Facelift
Facelift

What is a facelift
Also known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck.

What to expect during your consultation
The success and safety of your facelift depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss:

Why you want the surgery, your expectations and desired outcome
Medical conditions, drug allergies and medical treatments
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
Previous surgeries
Your surgeon may also:
Evaluate your general health status and any pre-existing health conditions or risk factors
Discuss the options available to you for facelift and facial rejuvenation
Examine and measure your face
Take photographs for your medical record
Discuss your options and recommend a course of treatment
Discuss likely outcomes of a facelift and any risks or potential complications
Discuss the type of anesthesia that will be used

Procedural Steps
What happens during facelift surgery?
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

A variety of other procedures can further enhance the outcome of a facelift. They include:

Facial implants
Soft tissue augmentation to recontour the facial structure
Resurfacing techniques to improve the tone and texture of facial skin
Wrinkle reduction by injection
Step 2 – The incision
Depending on the degree of change you’d like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift.

A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted.

Skin is redraped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.

Traditional Facelift

An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear and possibly within the lower eyelids or under the upper lip.

Limited Incision

Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.

Neck Lift

Step 3 – Closing the incisions
Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Step 4 – See the results
The visible improvements of a facelift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.
Important face about the safety and risks of facelift surgery
The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

The risks include:
Unfavorable scarring
Bleeding (hematoma)
Infection
Poor wound healing
Anesthesia risks
Correctable hair loss at the incisions
Facial nerve injury with weakness
Facial asymmetry
Skin loss
Numbness or other changes in skin sensation
Fatty tissue found deep in the skin might die (fat necrosis)
Fluid accumulation
Pain, which may persist
Skin contour irregularities
Skin discoloration, sensitivity or swelling
Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve your results)
Deep vein thrombosis, cardiac and pulmonary complications
Possibility of revisional surgery
Be sure to ask questions: It’s very important to ask your plastic surgeon questions about your facelift procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

A special note about the use of fibrin sealants (tissue glue)
Fibrin sealants (made from heat-treated human blood components to inactivate virus transmission) are used to hold tissue layers together at surgery and to diminish post-operative bruising following surgery.

This product has been carefully produced from screened donor blood plasma for hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have been used safely for many years as sealants in cardiovascular and general surgery. This product is thought to be of help in diminishing surgical bleeding and by adhering layers of tissue together.

When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

Be careful
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head. Your doctor will give you specific instructions on how to care for yourself.
My Recovery
When your procedure is completed, a bandage could gently be placed around your face to minimize swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.

You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?
The results will be long-lasting
It may take several months for swelling to fully dissipate and up to 6 months for incision lines to mature.

Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.
How much will facelift surgery cost?
Cost is always a consideration in elective surgery. Prices for facelifts can vary widely. A surgeon’s cost for facelift surgery may vary based on his or her experience as well as geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask.

Cost may include:

Surgeon’s fee
Hospital or surgical facility costs
Anesthesia fees
Prescriptions for medication
Post-surgery garments, and
Medical tests
Your satisfaction involves more than a fee
When choosing a plastic surgeon for facelift surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Most health insurance does not cover cosmetic surgery or its complications.
Words to know
General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
Hematoma: Blood pooling beneath the skin.
Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
Tear trough: Deep creases below the lower eyelids.
Nasolabial fold: Deep creases between the nose and cheek
Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone in the lower face.
Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
Rhytidectomy: A surgical procedure also known as facelift, to reduce sagging of the mid-face, jowls and neck.
Questions to ask your plastic surgeon
Use this checklist as a guide during your consultation
Are you certified by the American Board of Plastic Surgery?
Were you specifically trained in the field of plastic surgery?
How many years of plastic surgery training have you had?
Do you have hospital privileges to perform this procedure?
If so, at which hospitals?
Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?

Am I a good candidate for this procedure?
What will be expected of me to get the best results?
Where and how will you perform my procedure?
What surgical technique is recommended for me?
How long of a recovery period can I expect, and what kind of help will I need during my recovery?
What are the risks and complications associated with a facelift?
How are complications handled?
How can I expect my face to look over time?
What are my options if I am dissatisfied with the cosmetic outcome of my facelift?
Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me

All Materials 2009 ASPS/PSEF
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